How To Help A Friend With Depression

Back in January I wrote about my history with mental illness and briefly touched on the language we choose to talk about depression. Here, I'd like to give more practical advice about helping a friend with depression and what pitfalls to avoid, as I've had a bad year and more often than not, people just don't know what's for the best.

The stigma that surrounds mental illness means that we're not used to talking about it, so it's worth noting that it really is nobody's fault if they struggle. There's still a long way to go in addressing the wider social problems that prevent people from talking about mental illness, but the good news is that you can challenge these misconceptions and be a good friend just by rethinking your approach.

When I discuss my illness with friends they do one of two things: they try to relate to it or they try diminish it, both in a bid to make it seem less abnormal, I imagine. But think of it this way: if a friend broke their leg in a bicycle accident and they were in loads of pain, what would you do? You wouldn't tell them that your twisted ankle really hurts too (relating). You wouldn't tell them about your Aunt Mildred who broke her leg in twelve places as opposed to their three (diminishing). You wouldn't assume that they didn't need any help because they've broken their leg so of course they need all the help they can get.

In reality, you'd buy them a Get Well Soon card and get everyone to sign it. You'd visit them in hospital. You'd bring them their favourite snack. You'd lay on their hospital bed and watch Netflix. You'd tell them how much it sucked, that you were sorry and you loved them.

Your response to a depressed friend should be no different.

And yet I've never received a Get Well Soon card when I've had depression. Instead, people have felt compelled to remind me that "everyone feels down sometimes," as if my bed-ridden behaviour is an over-reaction. The Broken Leg Analogy works here too. Just imagine it: "Everyone's leg hurts sometimes Paula, stop making a fuss and walk."

It wouldn't happen because a broken leg is a visible illness with very visible ramifications. It's easy to see why someone in a cast would need a lot of TLC. But depression is less visible. It's more covert. Stigma makes sufferers hide it, deny it, waste precious energy putting on a show. Little do you know that behind closed doors, they are as paralysed as someone with a leg injury. Little do you know that they can't hold a conversation without having an internal anxiety attack about the intonation of their voice, the clumsiness of their sentence structure, the inauthenticity of their facial expressions. Little do you know that they can't control the urge to translate psychological pain into physical, to punish themselves for having the audacity to exist.

Don't forget. Depression is a disorder in an organ that happens to be the brain and the fact that the brain is most commonly associated with the self does not mean that mental disorders are self-inflicted. The Broken Leg Analogy helps to challenge this perspective and reframes how we categorise mental illnesses. For example:

'You don't seem depressed.' 'Your leg doesn't seem broken.'
'Depression is just a label.' 'Broken is just a label.'
'Avoid medication, it will mess with your head.' 'Avoid wearing a cast, it will mess with your leg.'
'You've got no reason to be depressed.' 'You've got no reason to have a broken leg.'

And it works the other way round, too.

'Get well soon!' 'Get well soon!'
'Just calling to check how you're doing.' 'Just calling to check how you're doing.'
'It must hurt like hell.' 'It must hurt like hell.'

Depression does hurt like hell. It hurts in the bones and the head and the heart. It eats away at the identity, renders the body immobile and robs your friend of their curiosity. It cuts them off from the world, switches the lights out and leaves them questioning everything. After all, if nobody else will recognise the seriousness of their illness, what's not to say that it's all in their head?

I can't state strongly enough how important validation is when people have depression. Anxiety, the bedfellow of depression, will try and trick them into thinking that it's all their fault, that it isn't real, and to be told that it isn't their fault, that their sickness is valid, is such a palpable relief.

So, what should you do if you find out that your friend has depression? Buy them a Get Well Soon card and get all your friends to sign it. Make them dinner. Lay in bed with them and watch Netflix. Tell them how much it sucks and how they don't deserve it and that you're sorry and you love them. Try not to ask them what they need as they'll be feeling very indecisive. Instead, access their needs yourself. Make sure they've showered recently, do their dishes, open the curtains, let some air in, buy a bunch of daffodils and put them on their bedside table, get them into some fresh PJs and do a load of washing.

They might not always want the company. They might just lay there in silence and barely register your presence. That's okay. Don't force them to engage with you. Don't take it personally. Whether or not they realise it at the time, these gestures contribute to the patchwork quilt of support that is fundamental to recovery. And when they do recover, they'll know that if depression threatens to break their brain again, you'll be there, ready to help them stick the pieces back together.